Kleinhendler-Lustig Dafna, Hamdan Sami, Mendlovic Joseph, Gvion Yari
Department of Psychology, Bar-Ilan University, Ramat Gan, Israel.
School of Behavioral Sciences, The Academic College of Tel-Jaffa (MTA), Tel-Jaffa, Israel.
Front Psychiatry. 2023 Jul 13;14:1211180. doi: 10.3389/fpsyt.2023.1211180. eCollection 2023.
There is limited data regarding the prevalence of suicidal risk among physicians during COVID-19, and the risk factors relating to it. Dominant risk factors for suicide among physicians are depression and burnout. Maladaptive perfectionism may also serve as a profound risk factor for suicidality among physicians and may aggravate symptoms of distress under the challenges of COVID-19. This study aims to evaluate current suicidal risk, suicidal ideation, depression, and burnout before and during COVID-19 among physicians in Israel, and to identify the best sets of correlates between perfectionism and burnout, depression and suicidal ideation, during these time periods.
A sample of 246 Israeli physicians (160 before COVID-19 and 86 during COVID-19) completed online surveys assessing lifetime suicidal risk, suicidal ideation during the last year and current suicidal ideation, depression, burnout symptoms and maladaptive perfectionism.
More than one-fifth of the sample (21.9%) reported high suicidal risk (Lifetime suicidal behaviors). More than one-fourth (27.2%) reported suicidal ideation during the last 12 months; and 13.4% reported suicidal ideation during the last 3 months. In addition, more than one-third (34.6%) exhibited moderate-severe levels of depressive symptoms and more than a half of the sample reported burnout symptoms. Maladaptive perfectionism was positively correlated with current suicidal ideation, burnout, and depression. Moderated serial mediation analysis demonstrated indirect effect of perfectionism on suicidal ideation by its impact on burnout and depression only during COVID-19. Before COVID-19, physicians were more likely to experience depressive symptoms.
Physicians in Israel are at increased risk for depression and suicidal ideation, regardless of the COVID-19 pandemic. Maladaptive perfectionism was found to be a risk factor for burnout, depression, and suicidal ideation. During the first waves of the pandemic, physicians were less likely to experience depressive symptoms. However, among physicians who were characterized with high maladaptive perfectionism, depression served as a significant risk factor for suicidal ideation during the pandemic, which places these individuals at increased risk for suicidality. These results highlight the importance of implementing intervention programs among physicians to reduce suicidal risk and to better identify rigid perfectionism and depressive symptoms.
关于新冠疫情期间医生自杀风险的患病率及其相关风险因素的数据有限。医生自杀的主要风险因素是抑郁和职业倦怠。适应不良的完美主义也可能是医生自杀倾向的一个重要风险因素，并且在新冠疫情的挑战下可能会加重痛苦症状。本研究旨在评估以色列医生在新冠疫情之前和期间当前的自杀风险、自杀意念、抑郁和职业倦怠情况，并确定在这些时间段内完美主义与职业倦怠、抑郁与自杀意念之间的最佳关联组合。
246名以色列医生的样本（160名在新冠疫情之前，86名在新冠疫情期间）完成了在线调查，评估终生自杀风险、过去一年的自杀意念和当前的自杀意念、抑郁、职业倦怠症状以及适应不良的完美主义。
超过五分之一的样本（21.9%）报告有高自杀风险（终生自杀行为）。超过四分之一（27.2%）的人报告在过去12个月中有自杀意念；13.4%的人报告在过去3个月中有自杀意念。此外，超过三分之一（34.6%）的人表现出中度至重度的抑郁症状，超过一半的样本报告有职业倦怠症状。适应不良的完美主义与当前的自杀意念、职业倦怠和抑郁呈正相关。调节序列中介分析表明，仅在新冠疫情期间，完美主义通过对职业倦怠和抑郁的影响对自杀意念产生间接效应。在新冠疫情之前，医生更容易出现抑郁症状。
无论新冠疫情如何，以色列的医生患抑郁症和自杀意念的风险都在增加。适应不良的完美主义被发现是职业倦怠、抑郁和自杀意念的一个风险因素。在疫情的第一波期间，医生出现抑郁症状的可能性较小。然而，在那些具有高度适应不良完美主义特征的医生中，抑郁在疫情期间是自杀意念的一个重要风险因素，这使得这些人自杀的风险增加。这些结果凸显了在医生中实施干预项目以降低自杀风险并更好地识别僵化完美主义和抑郁症状的重要性。
